FAQs

What was the decision on the location of A&E services in Southport, Formby and West Lancashire?
The joint committee made up of the integrated care boards of NHS Cheshire and Merseyside and NHS Lancashire and South Cumbria made a decision on the future location of A&E services in Southport, Formby and West Lancashire.

Following a rigorous and thoroughly detailed process including a 10-week pre-consultation engagement period and 13-week public consultation, the joint committee has decided to relocate the children’s A&E from Ormskirk Hospital to Southport Hospital and extend it to a 24-hour service, together with the existing 24-hour adult A&E.


As you’ve decided to proceed with the recommended way forward what does this mean for the future of both sites?
It is important to note, Southport and Ormskirk hospitals are not going anywhere.

Ormskirk Hospital’s children’s A&E and the relevant co-dependent service – paediatrics - will begin the process of moving across to Southport and our current estimates are that it will complete in a minimum of three years.

Ormskirk Hospital will remain open and continue to provide key services to patients, including outpatient services, urgent treatment, planned care, diagnostics, and inpatient services. There is active investment planned for the site and it’s vital to remember that currently 86% of activity is not A&E.


What will happen now?
Changes will not happen quickly. Our current estimates are that work on Southport Hospital would complete work in a minimum of three years.

The local NHS will continue to work closely with staff throughout the implementation phase. We will ensure colleagues are fully engaged, kept informed and involved in shaping how any changes are introduced, so that their views and experiences help guide a smooth and supportive transition.

What does this mean for people in Ormskirk and West Lancashire?
We have a duty of care to meet the urgent and emergency care needs of our communities which we will continue to do now and in the future.

NHS Lancashire and South Cumbria ICB is in the process of reprocuring some urgent care services in West Lancashire, including the walk-in-centre (WIC) in Skelmersdale and urgent treatment centre (UTC) at Ormskirk Hospital, which will ensure continuity of our current urgent care service offer in the area.

The procurement started in October 2025, with the aim of the new contract starting from July 2026. The contract will be for an initial period of three years, preceding any changes under the Shaping Care Together programme.

We will also be working on transforming integrated urgent care services across Lancashire and South Cumbria, including in West Lancashire, over the coming years.

It is important to note that 70 per cent of patients who present at children’s A&E in Ormskirk do not need to attend A&E. We are therefore strengthening our community offer – working with partners across the system to make sure we better meet the needs of patients closer to where they live.


What is being done about the travel issues raised during the consultation?
It is important to note that 70 per cent of patients who present at A&E do not need to attend A&E. We are therefore strengthening our community offer – working with partners across the system to make sure we better meet the needs of patients closer to where they live.

While the programme cannot resolve long-standing travel and transport issues, as this falls outside the remit of health, the established Travel Advisory Group (TAG) can raise these issues with local authorities and transport providers. The TAG will actively review travel analyses and consultation feedback to ensure transport issues are considered. The TAG brings together NHS organisations, local authorities, transport authorities, and local ambulance representatives to explore practical solutions and mitigations.

In line with NHS guidance, anyone needing emergency care should, where possible, be driven to A&E or call 999 for an ambulance. For non-emergency travel, we are working closely with local authorities and transport providers through the TAG to identify improvements in road access and public transport options, ensuring safe and convenient access for all communities.


I work at Ormskirk Hospital - how does this affect me and staff? What does this mean for my position at the hospital?
We understand that some staff have expressed concern about the impact of relocating services particularly for paediatrics. MWL will continue to work closely with staff, and we will ensure colleagues are fully engaged, kept informed and involved in shaping how any changes are introduced, so that all views and experiences help guide a smooth and supportive transition.

Our focus is on strengthening our workforce and improving the experience of everyone at MWL who help us deliver care every day. Our Integrated Impact Assessment found that improving supervision and training for resident doctors could help improve recruitment and retention, enhance MWL’s reputation and attract more trainees. The opportunity for A&E clinicians to manage both adults’ and children’s would also broaden skills and experience for both medical and nursing staff, supporting a more confident and flexible workforce.

There are wider workforce benefits too. A larger catchment area may improve recruitment, helping to reduce vacancy rates. The model could also lead to efficiencies in rota management and reduce current reliance on temporary staffing. Staff working in Urgent Treatment Centres and Walk-in Centres could further develop skills in caring for children with minor injuries, supporting career development and service resilience. Local access to major higher education institutions, including Edge Hill University and the University of Liverpool, means MWL is well placed to attract newly qualified doctors, nurses and trainees, strengthening recruitment pipelines into the service.

Our plans remain focussed on building a stronger, better-trained workforce and ensuring we can continue to provide a safe and sustainable 24/7 adults and children’s emergency service for local families.


Will there be enough car parking for the increased patient numbers?
We know parking can already be challenging at both sites. NHS guidance is, where possible, for people to either be driven to A&E or to call 999 for an ambulance so we must do our best to provide adequate on-site parking. Our proposals include expanded parking capacity to address this.


What are the consultation stats?
A total of more than 7,800 people actively engaged during the consultation period.

It was a significantly higher response rate compared to the typical UK public consultation average, this is a clear reflection of how important this decision is to our local communities.

This included:
- 5,009 online and hard copy survey responses received
- 14 public events saw over 800 people reached
- 507 people contacted via independent polling exercise: a representative sample of the population across the areas
- 10 public and staff focus groups with 60+ attendees
- 800+ people engaged with across 53 different community venues in West Lancashire
- 382 pieces of feedback to the Get Involved inbox
- 6 presentations and discussions at collaborative forums
- 2x Trust Brief Live sessions and 2x staff Q&A sessions

How does it compare to other NHS consultations?
The average response rate for UK public consultations stands at 0.7% - the Consultation Institute suggests 1% can be considered a good response rate.

The population of Southport, Formby and West Lancashire is approximately 246,000.

Over 2% have responded to the survey alone. And over 3% of the population have actively engaged with the programme.

How did you promote the consultation?
SCT promoted the consultation through a variety of channels so that they could reach as many people as possible. This included:

- 5,000+ summary consultation documents and leaflets distributed across community venues.
- 800+ people engaged with via community outreach at 53 different locations in West Lancashire.
- 110,000+ addresses in Southport, Formby, and West Lancashire were sent a leaflet by the programme advertising how to get involved and the public meetings.
- 273,000+ people reached via digital marketing for the consultation survey and events programme. This included targeted advertising aimed at demographics with lower response rates, such as younger males.
- Regular newsletters sent to 3,500+ subscribers.
- Materials including promotional collateral such as posters and leaflets were sent to local community organisations including libraries, community centres and patient groups.
- Media launch and proactive media activity generated 60+ pieces of coverage across local radio, online articles, TV, and print.
- 300+ leaflets and consultation documents were distributed during four drop-ins across both hospitals.
- Social media activity from both ICBs and the Trust promoted the consultation and events programme across social media platforms.

The consultation feedback report found that people said that there was a lack of information around maternity services?
It is important to note that at this current phase of the SCT programme, the joint committee have not taken a decision on maternity and neonatal services as these are out of scope.

Separate to the Shaping Care Together programme, NHS England are leading a regional service review that is happening across the north west looking at the provision for neonates. There is also an NHS England regional and national review ongoing for maternity.


What have you published?
We have published an independent report looking at responses to the Shaping Care Together consultation and our ‘You Said, We Did’ document, which sets out our responses to the main themes and issues raised during the consultation.


What equalities assessments have you done?
During pre-consultation engagement we completed a full and robust equalities impact assessment.

A full equalities impact has been updated and has been used to inform the DMBC. The full EIA has been published on the website.


Is the consultation still open?
No. The public consultation closed in October 2025 and remains closed.


Can I still submit feedback?
The consultation closed in October 2025 and remains closed. We cannot accept any new feedback.


How can I see the consultation feedback?
Feedback from the consultation is in the full independent consultation report published on the website here.


Did the consultation feedback change anything?
All consultation feedback has been considered alongside other evidence in the DMBC.

Feedback received during public consultation is an important factor in health service decision making. It is one of a number of important factors. Other factors include clinical, financial, equalities, and practical considerations.


Who analysed the consultation feedback?
An independent organisation called the Centre for Health Communication Research carried out the full analysis of all consultation feedback. All types of consultation responses are important, and the feedback report presents an independent analysis so that all of them may be taken into account by the programme.


If all A&E services move to Southport, which other services will have to move there too?
When deciding where to locate A&E services, we also have to think about what are called co-dependencies. These are services that must be available on the same site as A&E to ensure safe delivery of emergency care. If children’s A&E were to be relocated to Southport, one codependent service, the paediatric inpatient unit, would have to be moved along with it.

We use the classification of co-dependencies for emergency care produced by the South East Clinical Senate in 2024. This definition has been accepted by the NHS across England.


If all A&E services move to Ormskirk, which other services will have to move there too?
When deciding where to locate A&E services, we also have to think about what are called co-dependencies. These are services that must be available on the same site as A&E to ensure safe delivery of emergency care.

If adult A&E were to be relocated to Ormskirk, seven codependent services would have to be moved along with it: General medicine, critical care, elderly medicine, respiratory medicine, medical gastroenterology, urgent diagnostic haematology and biochemistry and liaison psychiatry.

We use the classification of co-dependencies for emergency care produced by the South East Clinical Senate in 2024. This definition has been accepted by the NHS across England.


Why do children's and adult A&E need to be on the same site?
Locating adult and children’s A&Es on the same site offers many important benefits. It would ensure that the workforce is in place to offer round-the-clock emergency care to children, that better anaesthetics cover for paediatric emergencies can be provided, and give better access to out-of-hours radiology.

There would also be operational benefits that would improve the response to critical situations and peaks in demand. Importantly though, current pressures mean services cannot continue as they are today without deterioration.


If you bring children’s and adult A&E together on a single site will children be mixed in with adult patients?
No. Children have specific needs which is why they receive emergency care in a dedicated, child-friendly environment where they can get age-appropriate care. Both sets of proposals include a dedicated entrance, waiting and treatment areas for children’s A&E. This allows for more tailored and effective care, ensuring young patients receive the best possible treatment in a safe and supportive environment.


Will there be enough staff and resources to operate 24 hours a day?
Yes. Locating adult and children’s A&Es on the same site offers many important benefits. One of these is ensuring that the workforce is in place to offer round-the-clock emergency care to both adults and children.


Why can’t you transfer adult A&E to Ormskirk?
We can, and that is one of two options included in the current consultation.


Why can’t we extend the hours of children’s A&E in Ormskirk?
We can. Both of the options we are consulting on include extending the opening hours of children’s A&E to 24 hours per-day. This would only be possible, however if we bring children’s and adult A&Es together on a single site.


Why is Ormskirk children's A&E closed overnight?
The combined pressures of having the staff needed, maintaining NHS buildings, and of funding, as well as an ageing population, mean we need to look for new ways to provide NHS services. Five years ago, these combined pressures, alongside considerations of patient safety, led to the difficult decision being taken to close children’s A&E at Ormskirk Hospital between midnight and 8am.


Why can’t we keep children’s A&E in Ormskirk?
We can, and that is one of two options included in the current consultation.


Isn't this all just an admission of NHS underfunding?
No. This is about doing better with current resources to meet people’s healthcare needs. Financial pressures are a part of the picture, but this isn’t all about money. We’re looking for ways to get the most from all available resources which also includes our staff, buildings and estates.


How much will this all cost?
Current implementation costs are estimated at £33.1 million for the Southport option and £91.3 million for the Ormskirk option. You can find out more about how these costs were calculated in our Estates Feasibility study on our website.


Will this save the NHS money?
Our goal is to do more and better with the resources we have. The proposals would allow for improved service delivery, but we would also expect to see some significant future operational efficiencies by, for example, reducing reliance on more expensive locum and agency staff.


Why were the costs for Southport option lowered just before the start of consultation?
Shortly before publication of our pre-consultation business case on July 4, we identified some double counting in the independent architect’s report. Specifically, this included the incorrect inclusion of gynaecology as a co-dependent service and a duplication in the area allocated for the relocation of paediatric inpatients. This lowered the estimated cost of the Southport option from around £45 million to £33 million.


Why is there such a big difference in cost between the two options?
The most significant factor behind the cost differences of the two options is the scale of redevelopment required. To understand this, we need to consider what we call codependent services. These are the services that must be located alongside A&E for emergency care to be delivered safely. The Southport option would require one other service to move from Ormskirk to Southport (paediatric inpatients), needing 1,800 m2 for redevelopment. The Ormskirk option would require the relocation of at least seven other services and need 8,800 m2 redevelopment space.


The Ormskirk option cost is £91m and the Southport option £33m. Where would this extra money come from?
The trust has already set aside some funding for service reconfiguration. Whichever option is chosen, however, we know that additional funding will be required.

We cannot know how much before deciding which site is to be redeveloped and forming more detailed plans. NHS England would make the final decision on any additional funding required.


What is a public consultation?
A consultation is when public bodies, like the NHS, ask for feedback from the public on things like policy ideas or service changes. It is a way of hearing opinions, concerns and suggestions before making decisions. Doing this helps us to make better decisions and builds trust with the people we serve.


Who can take part?
Anyone is welcome to contribute their views, but we especially want to hear from:

  • Patients, families and carers.
  • Underrepresented groups and communities.
  • Our staff and their representatives.
  • People from protected characteristic backgrounds as defined in the Equalities Act 2010.
  • Community, voluntary and faith groups.
  • Organisations who work with or depend on the local NHS.

People from neighbouring areas who may use and rely on NHS services here.


Have you calculated how long it will take for ambulances to reach A&E from the most rural areas during rush hour traffic?
North West Ambulance Service (NWAS) have modelled the possible impacts of each option on ambulance journey times. You can find out more in their report, available on our website.


Will there be enough car parking for the increased patient numbers?
We know parking can already be challenging at both sites. NHS guidance is, where possible, for people to either be driven to A&E or to call 999 for an ambulance so we must do our best to provide adequate on-site parking. Both sets of proposals include expanded parking capacity to address this.


Have you thought about how people who don't have someone to drive them, will get to A&E?
People who do not have somebody to drive them to A&E should call 999 for an ambulance, in line with NHS guidance. More information on how the options could impact ambulance journey times can be found in our consultation booklet.


Will there be enough public transport in place to get people to A&E from all areas of Southport, Formby and West Lancashire?
NHS guidance is, where possible, for people to either be driven to A&E or to call 999 for an ambulance. We understand, however, that sometimes people need to rely on public transport. More information on how the options could affect journey times by public transport can be found in our travel impact assessment. We remain committed to working with local authorities and public transport providers to help make sure services are developed to reflect the needs of patients and staff to access our hospital sites.


How long will it take before the work is finished?
This depends on which option is chosen. Our estimates are that the Southport option would take around five years to complete (two years preparation and three years for the works), and that the Ormskirk option would take around seven years to complete (three years preparation and four years for the works).


Why will it take less time to finish work for the Southport option?
The most significant factor behind the difference between the two options is the scale of redevelopment required. To understand this, we need to consider what we call codependent services. These are the services that must be located alongside A&E for emergency care to be delivered safely. The Southport option would require one other service to move from Ormskirk to Southport (paediatric inpatients), needing 1,800 m2 for redevelopment. The Ormskirk option would require the relocation of at least seven other services and need 8,800 m2 redevelopment space.


How will maternity services be affected?
When we launched the Shaping Care Together programme, we identified a number of NHS services that may need to change so that we can continue to offer excellent quality services, in a safe environment, in the years to come. Of these, we have started by looking at urgent and emergency care. This is because getting it right there can help improve the flow of patients and service delivery across the wider hospital site. Maternity services are not part of the current scope, and any long-term sustainable service change would be subject to patient, public, staff and stakeholder engagement.


Why is Southport the preferred option?
When our assessment panel looked at the evidence for both options, some of the more significant differences were that the Southport option could:

  • Be delivered two years quicker than the seven years needed for the Ormskirk option.
  • Need one other service to be moved compared to seven services for the Ormskirk option.
  • Require less space for redevelopment - 1,800 m2 rather than 8,800 m2.
  • Cost significantly less - £33.1 million rather than £91.3 million.

This led the panel to advise that Southport should be a preferred option. When deciding on what to include in the consultation, the programme followed that advice.


Who is the joint committee that is making the decisions?
In autumn last year, the two Integrated Care Boards responsible for commissioning services in our area (NHS Cheshire and Merseyside and NHS Lancashire and South Cumbria), decided to streamline the decision-making process for the Shaping Care Together programme and set up a joint committee with delegated authority. The members of the joint committee also sit on the boards of the two ICBs.


Who came up with the two options?
In 2024 we invited views from people who use and rely on our services on how to change the way we deliver urgent and emergency care. Over 3,000 people responded. The many ideas we received were assessed by a panel led by NHS clinical experts supported by:

  • Members of the public, patients and staff.
  • NHS non-clinical experts including those working on estates, financial and workforce planning, management and development.
  • NHS commissioners and staff from neighbouring trusts.
  • Representatives from local Healthwatch groups and from the wider community and voluntary sector in our area.
  • Local groups that represent patients and service users.

The programme took the panel’s advice to include two options for public consultation.


If all A&E services go to Ormskirk, will the facilities left in the Southport and Formby area be adequate to serve the urgent care needs of residents there?
We have a duty of care to the people who use and rely on our services. That includes developing services to meet the urgent and emergency care needs of our communities. We will continue to do that whatever the outcome of this consultation. The proposals in this consultation will help us do that.

Once decisions have been made on where to locate our A&Es we will take stock of our needs for urgent care before we start making any changes to services on the ground.


If all A&E services go to Ormskirk, will you open an Urgent Treatment Centre in Southport?
We have a duty of care to the people who use and rely on our services. That includes developing services to meet the urgent and emergency care needs of our communities. We will continue to do that whatever the outcome of this consultation. The proposals in this consultation will help us do that.

Once decisions have been made on where to locate our A&Es we will take stock of our needs for urgent care before we start making any changes to services on the ground.


If all A&E services go to Southport will the Walk-in-Centre in Skelmersdale be upgraded to an Urgent Treatment Centre? Will it have sufficient staffing? Will they be available 24 hours a day?
We have a duty of care to the people who use and rely on our services. That includes developing services to meet the urgent and emergency care needs of our communities. We will continue to do that whatever the outcome of this consultation. The proposals in this consultation will help us do that.

Work is already underway for recommissioning some of our urgent care services independent of the Shaping Care Together programme. This is because some contracts are approaching their end dates. Proposals for how theses service may look in future, including staffing levels and operating hours, will reflect the outcome of this consultation. Should proposals include any significant changes to how the service is offered, they would also be subject to public consultation, as required.

Once decisions have been made on where to locate our A&Es we will take stock of our needs for urgent care before we start making any changes to services on the ground.


If all A&E services go Southport will you upgrade the Urgent Treatment Centre in Ormskirk to 24 hours a day? Will it have sufficient staffing?
We have a duty of care to the people who use and rely on our services. That includes developing services to meet the urgent and emergency care needs of our communities. We will continue to do that whatever the outcome of this consultation. The proposals in this consultation will help us do that.

Work is already underway for recommissioning some of our urgent care services independent of the Shaping Care Together programme. This is because some contracts are approaching their end dates. Proposals for how theses service may look in future, including staffing levels and operating hours, will reflect the outcome of this consultation. Should proposals include any significant changes to how the service is offered, they would also be subject to public consultation, as required.

Once decisions have been made on where to locate our A&Es we will take stock of our needs for urgent care before we start making any changes to services on the ground.


What buildings have recently been purchased by Mersey and West Lancashire Teaching Hospitals NHS Trust at Ormskirk Hospitals and why? Can these be used for the new adult A&E department in the Ormskirk Option? Can I arrange a visit to these sites?
In March 2024 Mersey and West Lancashire Teaching Hospitals NHS Trust acquired buildings from NHS Property Services and Lancashire Care NHS Foundation Trust. These were Hilldale, CDC (Child Development Centre), Bickerstaffe House, Diabetes Centre and Old PCT HQ. These acquisitions were undertaken to restore the integrity of the site, to provide options for future development of services on the Ormskirk site, and so that these pockets of land were not sold to developers, which could be needed by the Trust.

None of these buildings would be suitable to house a new adult emergency department, because they are not co-located with the children’s emergency department and other essential services, such as theatres and Intensive care beds that are needed to support an emergency service, however they do provide options to move other services out of the core of the main hospital building, should the Shaping Care Together public consultation determine Ormskirk Hospital as the way forward.

Unfortunately, we’re unable to offer site visits as the buildings contain asbestos, which poses a health risk. However, photos of the site can be found here.


How have the cost estimates for the new car parks at Southport and Ormskirk been developed?
The cost estimates for the proposed new car parks at both Southport and Ormskirk have been developed by independent specialists using a consistent methodology.

The car park cost rates and allowances are based on a recently completed 100-space deck car park at another hospital. These same rates have been applied across both sites to ensure the pricing approach is consistent, with variances derived only from the number of spaces/sizes applicable to each site.

This approach ensures the estimates are robust, consistently applied, and informed by recent comparable NHS infrastructure projects.

Please see breakdown below:

Ormskirk:

  • Deck Car Park: deck car park, barrier height extension, foundations (pads), foundations (ramp), drainage connections, CBR testing (5 nr locations), ground radar and drainage survey, external lighting, external CCTV, power and data supplies (including BWIC), height limit barriers, lightning protection (earthing pits)
  • Lower-Level Surface Parking: break out existing tarmac, excavate to reduced levels, hardcore sub-base and geotextile barrier, tarmac surfacing, white lining, drainage installations
  • Other: traffic management, modifications to road access
  • Construction on-costs: general prelims and management, temporary electrics package (rate per m2), scaffold and access package (rate per m2), final clean (rate per m2), fixed price allowance, main contractor’s: pre-construction fees, design fees, risk and overheads & profit/P23 fee.
  • Project Fees: consultant fees, in-house staff costs, surveys and investigations, legal fees
  • Direct Costs: non-works, equipment, IT & digital system enhancements (excluded)
  • Risk & Optimism Bias: planning contingency, optimism bias
  • Inflation: tender price inflation
  • Value Added Tax: VAT on all costs other than fees, VAT recovery on refurbishment works, VAT recovery on business activity works (i.e. car parking)


Southport:

  • Deck Car Park: deck car park, barrier height extension, foundations (pads), foundations (ramp), drainage connections, CBR testing (5 nr locations), ground radar and drainage survey, external lighting, external CCTV, power and data supplies (including BWIC), height limit barriers, lightning protection (earthing pits)
  • Lower-Level Surface Parking: break out existing tarmac, excavate to reduced levels, hardcore sub-base and geotextile barrier, tarmac surfacing, white lining, drainage installations
  • Surface Parking: surface level car park (including surfacing and kerbs), groundworks, make good retained building interfaces, drainage to new car park, drainage modifications to existing, CBR testing (5 nr locations), ground radar and drainage survey, external lighting, external CCTV, power and data supplies (including BWIC), white lining, lightning protection (earthing pits)
  • Other Site Works: traffic management, modifications to road access
  • Construction on-costs: main contractor general prelims and management, temporary electrics package (rate per m2), scaffold and access package (rate per m2), final clean (rate per m2), fixed price allowance, main contract’s: pre-construction fees, design fees, risk, overheads & profit / P23 fee.
  • Project Fees: consultant fees, in-house staff costs, surveys and investigations, legal fees
  • Direct Costs: non-works, equipment, IT & digital system enhancements (excluded)
  • Risk & Optimism Bias: planning contingency, optimism bias
  • Inflation: tender price inflation
  • Value Added Tax: VAT on all costs other than fees, VAT recovery on refurbishment works, VAT recovery on business activity works (i.e. car parking)


What was the decision on the location of A&E services in Southport, Formby and West Lancashire?
The joint committee made up of the integrated care boards of NHS Cheshire and Merseyside and NHS Lancashire and South Cumbria made a decision on the future location of A&E services in Southport, Formby and West Lancashire.

Following a rigorous and thoroughly detailed process including a 10-week pre-consultation engagement period and 13-week public consultation, the joint committee has decided to relocate the children’s A&E from Ormskirk Hospital to Southport Hospital and extend it to a 24-hour service, together with the existing 24-hour adult A&E.


As you’ve decided to proceed with the recommended way forward what does this mean for the future of both sites?
It is important to note, Southport and Ormskirk hospitals are not going anywhere.

Ormskirk Hospital’s children’s A&E and the relevant co-dependent service – paediatrics - will begin the process of moving across to Southport and our current estimates are that it will complete in a minimum of three years.

Ormskirk Hospital will remain open and continue to provide key services to patients, including outpatient services, urgent treatment, planned care, diagnostics, and inpatient services. There is active investment planned for the site and it’s vital to remember that currently 86% of activity is not A&E.


What will happen now?
Changes will not happen quickly. Our current estimates are that work on Southport Hospital would complete work in a minimum of three years.

The local NHS will continue to work closely with staff throughout the implementation phase. We will ensure colleagues are fully engaged, kept informed and involved in shaping how any changes are introduced, so that their views and experiences help guide a smooth and supportive transition.

What does this mean for people in Ormskirk and West Lancashire?
We have a duty of care to meet the urgent and emergency care needs of our communities which we will continue to do now and in the future.

NHS Lancashire and South Cumbria ICB is in the process of reprocuring some urgent care services in West Lancashire, including the walk-in-centre (WIC) in Skelmersdale and urgent treatment centre (UTC) at Ormskirk Hospital, which will ensure continuity of our current urgent care service offer in the area.

The procurement started in October 2025, with the aim of the new contract starting from July 2026. The contract will be for an initial period of three years, preceding any changes under the Shaping Care Together programme.

We will also be working on transforming integrated urgent care services across Lancashire and South Cumbria, including in West Lancashire, over the coming years.

It is important to note that 70 per cent of patients who present at children’s A&E in Ormskirk do not need to attend A&E. We are therefore strengthening our community offer – working with partners across the system to make sure we better meet the needs of patients closer to where they live.


What is being done about the travel issues raised during the consultation?
It is important to note that 70 per cent of patients who present at A&E do not need to attend A&E. We are therefore strengthening our community offer – working with partners across the system to make sure we better meet the needs of patients closer to where they live.

While the programme cannot resolve long-standing travel and transport issues, as this falls outside the remit of health, the established Travel Advisory Group (TAG) can raise these issues with local authorities and transport providers. The TAG will actively review travel analyses and consultation feedback to ensure transport issues are considered. The TAG brings together NHS organisations, local authorities, transport authorities, and local ambulance representatives to explore practical solutions and mitigations.

In line with NHS guidance, anyone needing emergency care should, where possible, be driven to A&E or call 999 for an ambulance. For non-emergency travel, we are working closely with local authorities and transport providers through the TAG to identify improvements in road access and public transport options, ensuring safe and convenient access for all communities.


I work at Ormskirk Hospital - how does this affect me and staff? What does this mean for my position at the hospital?
We understand that some staff have expressed concern about the impact of relocating services particularly for paediatrics. MWL will continue to work closely with staff, and we will ensure colleagues are fully engaged, kept informed and involved in shaping how any changes are introduced, so that all views and experiences help guide a smooth and supportive transition.

Our focus is on strengthening our workforce and improving the experience of everyone at MWL who help us deliver care every day. Our Integrated Impact Assessment found that improving supervision and training for resident doctors could help improve recruitment and retention, enhance MWL’s reputation and attract more trainees. The opportunity for A&E clinicians to manage both adults’ and children’s would also broaden skills and experience for both medical and nursing staff, supporting a more confident and flexible workforce.

There are wider workforce benefits too. A larger catchment area may improve recruitment, helping to reduce vacancy rates. The model could also lead to efficiencies in rota management and reduce current reliance on temporary staffing. Staff working in Urgent Treatment Centres and Walk-in Centres could further develop skills in caring for children with minor injuries, supporting career development and service resilience. Local access to major higher education institutions, including Edge Hill University and the University of Liverpool, means MWL is well placed to attract newly qualified doctors, nurses and trainees, strengthening recruitment pipelines into the service.

Our plans remain focussed on building a stronger, better-trained workforce and ensuring we can continue to provide a safe and sustainable 24/7 adults and children’s emergency service for local families.


Will there be enough car parking for the increased patient numbers?
We know parking can already be challenging at both sites. NHS guidance is, where possible, for people to either be driven to A&E or to call 999 for an ambulance so we must do our best to provide adequate on-site parking. Our proposals include expanded parking capacity to address this.


What are the consultation stats?
A total of more than 7,800 people actively engaged during the consultation period.

It was a significantly higher response rate compared to the typical UK public consultation average, this is a clear reflection of how important this decision is to our local communities.

This included:
- 5,009 online and hard copy survey responses received
- 14 public events saw over 800 people reached
- 507 people contacted via independent polling exercise: a representative sample of the population across the areas
- 10 public and staff focus groups with 60+ attendees
- 800+ people engaged with across 53 different community venues in West Lancashire
- 382 pieces of feedback to the Get Involved inbox
- 6 presentations and discussions at collaborative forums
- 2x Trust Brief Live sessions and 2x staff Q&A sessions

How does it compare to other NHS consultations?
The average response rate for UK public consultations stands at 0.7% - the Consultation Institute suggests 1% can be considered a good response rate.

The population of Southport, Formby and West Lancashire is approximately 246,000.

Over 2% have responded to the survey alone. And over 3% of the population have actively engaged with the programme.

How did you promote the consultation?
SCT promoted the consultation through a variety of channels so that they could reach as many people as possible. This included:

- 5,000+ summary consultation documents and leaflets distributed across community venues.
- 800+ people engaged with via community outreach at 53 different locations in West Lancashire.
- 110,000+ addresses in Southport, Formby, and West Lancashire were sent a leaflet by the programme advertising how to get involved and the public meetings.
- 273,000+ people reached via digital marketing for the consultation survey and events programme. This included targeted advertising aimed at demographics with lower response rates, such as younger males.
- Regular newsletters sent to 3,500+ subscribers.
- Materials including promotional collateral such as posters and leaflets were sent to local community organisations including libraries, community centres and patient groups.
- Media launch and proactive media activity generated 60+ pieces of coverage across local radio, online articles, TV, and print.
- 300+ leaflets and consultation documents were distributed during four drop-ins across both hospitals.
- Social media activity from both ICBs and the Trust promoted the consultation and events programme across social media platforms.

The consultation feedback report found that people said that there was a lack of information around maternity services?
It is important to note that at this current phase of the SCT programme, the joint committee have not taken a decision on maternity and neonatal services as these are out of scope.

Separate to the Shaping Care Together programme, NHS England are leading a regional service review that is happening across the north west looking at the provision for neonates. There is also an NHS England regional and national review ongoing for maternity.


What have you published?
We have published an independent report looking at responses to the Shaping Care Together consultation and our ‘You Said, We Did’ document, which sets out our responses to the main themes and issues raised during the consultation.


What equalities assessments have you done?
During pre-consultation engagement we completed a full and robust equalities impact assessment.

A full equalities impact has been updated and has been used to inform the DMBC. The full EIA has been published on the website.


Is the consultation still open?
No. The public consultation closed in October 2025 and remains closed.


Can I still submit feedback?
The consultation closed in October 2025 and remains closed. We cannot accept any new feedback.


How can I see the consultation feedback?
Feedback from the consultation is in the full independent consultation report published on the website here.


Did the consultation feedback change anything?
All consultation feedback has been considered alongside other evidence in the DMBC.

Feedback received during public consultation is an important factor in health service decision making. It is one of a number of important factors. Other factors include clinical, financial, equalities, and practical considerations.


Who analysed the consultation feedback?
An independent organisation called the Centre for Health Communication Research carried out the full analysis of all consultation feedback. All types of consultation responses are important, and the feedback report presents an independent analysis so that all of them may be taken into account by the programme.


If all A&E services move to Southport, which other services will have to move there too?
When deciding where to locate A&E services, we also have to think about what are called co-dependencies. These are services that must be available on the same site as A&E to ensure safe delivery of emergency care. If children’s A&E were to be relocated to Southport, one codependent service, the paediatric inpatient unit, would have to be moved along with it.

We use the classification of co-dependencies for emergency care produced by the South East Clinical Senate in 2024. This definition has been accepted by the NHS across England.


If all A&E services move to Ormskirk, which other services will have to move there too?
When deciding where to locate A&E services, we also have to think about what are called co-dependencies. These are services that must be available on the same site as A&E to ensure safe delivery of emergency care.

If adult A&E were to be relocated to Ormskirk, seven codependent services would have to be moved along with it: General medicine, critical care, elderly medicine, respiratory medicine, medical gastroenterology, urgent diagnostic haematology and biochemistry and liaison psychiatry.

We use the classification of co-dependencies for emergency care produced by the South East Clinical Senate in 2024. This definition has been accepted by the NHS across England.


Why do children's and adult A&E need to be on the same site?
Locating adult and children’s A&Es on the same site offers many important benefits. It would ensure that the workforce is in place to offer round-the-clock emergency care to children, that better anaesthetics cover for paediatric emergencies can be provided, and give better access to out-of-hours radiology.

There would also be operational benefits that would improve the response to critical situations and peaks in demand. Importantly though, current pressures mean services cannot continue as they are today without deterioration.


If you bring children’s and adult A&E together on a single site will children be mixed in with adult patients?
No. Children have specific needs which is why they receive emergency care in a dedicated, child-friendly environment where they can get age-appropriate care. Both sets of proposals include a dedicated entrance, waiting and treatment areas for children’s A&E. This allows for more tailored and effective care, ensuring young patients receive the best possible treatment in a safe and supportive environment.


Will there be enough staff and resources to operate 24 hours a day?
Yes. Locating adult and children’s A&Es on the same site offers many important benefits. One of these is ensuring that the workforce is in place to offer round-the-clock emergency care to both adults and children.


Why can’t you transfer adult A&E to Ormskirk?
We can, and that is one of two options included in the current consultation.


Why can’t we extend the hours of children’s A&E in Ormskirk?
We can. Both of the options we are consulting on include extending the opening hours of children’s A&E to 24 hours per-day. This would only be possible, however if we bring children’s and adult A&Es together on a single site.


Why is Ormskirk children's A&E closed overnight?
The combined pressures of having the staff needed, maintaining NHS buildings, and of funding, as well as an ageing population, mean we need to look for new ways to provide NHS services. Five years ago, these combined pressures, alongside considerations of patient safety, led to the difficult decision being taken to close children’s A&E at Ormskirk Hospital between midnight and 8am.


Why can’t we keep children’s A&E in Ormskirk?
We can, and that is one of two options included in the current consultation.


Isn't this all just an admission of NHS underfunding?
No. This is about doing better with current resources to meet people’s healthcare needs. Financial pressures are a part of the picture, but this isn’t all about money. We’re looking for ways to get the most from all available resources which also includes our staff, buildings and estates.


How much will this all cost?
Current implementation costs are estimated at £33.1 million for the Southport option and £91.3 million for the Ormskirk option. You can find out more about how these costs were calculated in our Estates Feasibility study on our website.


Will this save the NHS money?
Our goal is to do more and better with the resources we have. The proposals would allow for improved service delivery, but we would also expect to see some significant future operational efficiencies by, for example, reducing reliance on more expensive locum and agency staff.


Why were the costs for Southport option lowered just before the start of consultation?
Shortly before publication of our pre-consultation business case on July 4, we identified some double counting in the independent architect’s report. Specifically, this included the incorrect inclusion of gynaecology as a co-dependent service and a duplication in the area allocated for the relocation of paediatric inpatients. This lowered the estimated cost of the Southport option from around £45 million to £33 million.


Why is there such a big difference in cost between the two options?
The most significant factor behind the cost differences of the two options is the scale of redevelopment required. To understand this, we need to consider what we call codependent services. These are the services that must be located alongside A&E for emergency care to be delivered safely. The Southport option would require one other service to move from Ormskirk to Southport (paediatric inpatients), needing 1,800 m2 for redevelopment. The Ormskirk option would require the relocation of at least seven other services and need 8,800 m2 redevelopment space.


The Ormskirk option cost is £91m and the Southport option £33m. Where would this extra money come from?
The trust has already set aside some funding for service reconfiguration. Whichever option is chosen, however, we know that additional funding will be required.

We cannot know how much before deciding which site is to be redeveloped and forming more detailed plans. NHS England would make the final decision on any additional funding required.


What is a public consultation?
A consultation is when public bodies, like the NHS, ask for feedback from the public on things like policy ideas or service changes. It is a way of hearing opinions, concerns and suggestions before making decisions. Doing this helps us to make better decisions and builds trust with the people we serve.


Who can take part?
Anyone is welcome to contribute their views, but we especially want to hear from:

  • Patients, families and carers.
  • Underrepresented groups and communities.
  • Our staff and their representatives.
  • People from protected characteristic backgrounds as defined in the Equalities Act 2010.
  • Community, voluntary and faith groups.
  • Organisations who work with or depend on the local NHS.

People from neighbouring areas who may use and rely on NHS services here.


Have you calculated how long it will take for ambulances to reach A&E from the most rural areas during rush hour traffic?
North West Ambulance Service (NWAS) have modelled the possible impacts of each option on ambulance journey times. You can find out more in their report, available on our website.


Will there be enough car parking for the increased patient numbers?
We know parking can already be challenging at both sites. NHS guidance is, where possible, for people to either be driven to A&E or to call 999 for an ambulance so we must do our best to provide adequate on-site parking. Both sets of proposals include expanded parking capacity to address this.


Have you thought about how people who don't have someone to drive them, will get to A&E?
People who do not have somebody to drive them to A&E should call 999 for an ambulance, in line with NHS guidance. More information on how the options could impact ambulance journey times can be found in our consultation booklet.


Will there be enough public transport in place to get people to A&E from all areas of Southport, Formby and West Lancashire?
NHS guidance is, where possible, for people to either be driven to A&E or to call 999 for an ambulance. We understand, however, that sometimes people need to rely on public transport. More information on how the options could affect journey times by public transport can be found in our travel impact assessment. We remain committed to working with local authorities and public transport providers to help make sure services are developed to reflect the needs of patients and staff to access our hospital sites.


How long will it take before the work is finished?
This depends on which option is chosen. Our estimates are that the Southport option would take around five years to complete (two years preparation and three years for the works), and that the Ormskirk option would take around seven years to complete (three years preparation and four years for the works).


Why will it take less time to finish work for the Southport option?
The most significant factor behind the difference between the two options is the scale of redevelopment required. To understand this, we need to consider what we call codependent services. These are the services that must be located alongside A&E for emergency care to be delivered safely. The Southport option would require one other service to move from Ormskirk to Southport (paediatric inpatients), needing 1,800 m2 for redevelopment. The Ormskirk option would require the relocation of at least seven other services and need 8,800 m2 redevelopment space.


How will maternity services be affected?
When we launched the Shaping Care Together programme, we identified a number of NHS services that may need to change so that we can continue to offer excellent quality services, in a safe environment, in the years to come. Of these, we have started by looking at urgent and emergency care. This is because getting it right there can help improve the flow of patients and service delivery across the wider hospital site. Maternity services are not part of the current scope, and any long-term sustainable service change would be subject to patient, public, staff and stakeholder engagement.


Why is Southport the preferred option?
When our assessment panel looked at the evidence for both options, some of the more significant differences were that the Southport option could:

  • Be delivered two years quicker than the seven years needed for the Ormskirk option.
  • Need one other service to be moved compared to seven services for the Ormskirk option.
  • Require less space for redevelopment - 1,800 m2 rather than 8,800 m2.
  • Cost significantly less - £33.1 million rather than £91.3 million.

This led the panel to advise that Southport should be a preferred option. When deciding on what to include in the consultation, the programme followed that advice.


Who is the joint committee that is making the decisions?
In autumn last year, the two Integrated Care Boards responsible for commissioning services in our area (NHS Cheshire and Merseyside and NHS Lancashire and South Cumbria), decided to streamline the decision-making process for the Shaping Care Together programme and set up a joint committee with delegated authority. The members of the joint committee also sit on the boards of the two ICBs.


Who came up with the two options?
In 2024 we invited views from people who use and rely on our services on how to change the way we deliver urgent and emergency care. Over 3,000 people responded. The many ideas we received were assessed by a panel led by NHS clinical experts supported by:

  • Members of the public, patients and staff.
  • NHS non-clinical experts including those working on estates, financial and workforce planning, management and development.
  • NHS commissioners and staff from neighbouring trusts.
  • Representatives from local Healthwatch groups and from the wider community and voluntary sector in our area.
  • Local groups that represent patients and service users.

The programme took the panel’s advice to include two options for public consultation.


If all A&E services go to Ormskirk, will the facilities left in the Southport and Formby area be adequate to serve the urgent care needs of residents there?
We have a duty of care to the people who use and rely on our services. That includes developing services to meet the urgent and emergency care needs of our communities. We will continue to do that whatever the outcome of this consultation. The proposals in this consultation will help us do that.

Once decisions have been made on where to locate our A&Es we will take stock of our needs for urgent care before we start making any changes to services on the ground.


If all A&E services go to Ormskirk, will you open an Urgent Treatment Centre in Southport?
We have a duty of care to the people who use and rely on our services. That includes developing services to meet the urgent and emergency care needs of our communities. We will continue to do that whatever the outcome of this consultation. The proposals in this consultation will help us do that.

Once decisions have been made on where to locate our A&Es we will take stock of our needs for urgent care before we start making any changes to services on the ground.


If all A&E services go to Southport will the Walk-in-Centre in Skelmersdale be upgraded to an Urgent Treatment Centre? Will it have sufficient staffing? Will they be available 24 hours a day?
We have a duty of care to the people who use and rely on our services. That includes developing services to meet the urgent and emergency care needs of our communities. We will continue to do that whatever the outcome of this consultation. The proposals in this consultation will help us do that.

Work is already underway for recommissioning some of our urgent care services independent of the Shaping Care Together programme. This is because some contracts are approaching their end dates. Proposals for how theses service may look in future, including staffing levels and operating hours, will reflect the outcome of this consultation. Should proposals include any significant changes to how the service is offered, they would also be subject to public consultation, as required.

Once decisions have been made on where to locate our A&Es we will take stock of our needs for urgent care before we start making any changes to services on the ground.


If all A&E services go Southport will you upgrade the Urgent Treatment Centre in Ormskirk to 24 hours a day? Will it have sufficient staffing?
We have a duty of care to the people who use and rely on our services. That includes developing services to meet the urgent and emergency care needs of our communities. We will continue to do that whatever the outcome of this consultation. The proposals in this consultation will help us do that.

Work is already underway for recommissioning some of our urgent care services independent of the Shaping Care Together programme. This is because some contracts are approaching their end dates. Proposals for how theses service may look in future, including staffing levels and operating hours, will reflect the outcome of this consultation. Should proposals include any significant changes to how the service is offered, they would also be subject to public consultation, as required.

Once decisions have been made on where to locate our A&Es we will take stock of our needs for urgent care before we start making any changes to services on the ground.


What buildings have recently been purchased by Mersey and West Lancashire Teaching Hospitals NHS Trust at Ormskirk Hospitals and why? Can these be used for the new adult A&E department in the Ormskirk Option? Can I arrange a visit to these sites?
In March 2024 Mersey and West Lancashire Teaching Hospitals NHS Trust acquired buildings from NHS Property Services and Lancashire Care NHS Foundation Trust. These were Hilldale, CDC (Child Development Centre), Bickerstaffe House, Diabetes Centre and Old PCT HQ. These acquisitions were undertaken to restore the integrity of the site, to provide options for future development of services on the Ormskirk site, and so that these pockets of land were not sold to developers, which could be needed by the Trust.

None of these buildings would be suitable to house a new adult emergency department, because they are not co-located with the children’s emergency department and other essential services, such as theatres and Intensive care beds that are needed to support an emergency service, however they do provide options to move other services out of the core of the main hospital building, should the Shaping Care Together public consultation determine Ormskirk Hospital as the way forward.

Unfortunately, we’re unable to offer site visits as the buildings contain asbestos, which poses a health risk. However, photos of the site can be found here.


How have the cost estimates for the new car parks at Southport and Ormskirk been developed?
The cost estimates for the proposed new car parks at both Southport and Ormskirk have been developed by independent specialists using a consistent methodology.

The car park cost rates and allowances are based on a recently completed 100-space deck car park at another hospital. These same rates have been applied across both sites to ensure the pricing approach is consistent, with variances derived only from the number of spaces/sizes applicable to each site.

This approach ensures the estimates are robust, consistently applied, and informed by recent comparable NHS infrastructure projects.

Please see breakdown below:

Ormskirk:

  • Deck Car Park: deck car park, barrier height extension, foundations (pads), foundations (ramp), drainage connections, CBR testing (5 nr locations), ground radar and drainage survey, external lighting, external CCTV, power and data supplies (including BWIC), height limit barriers, lightning protection (earthing pits)
  • Lower-Level Surface Parking: break out existing tarmac, excavate to reduced levels, hardcore sub-base and geotextile barrier, tarmac surfacing, white lining, drainage installations
  • Other: traffic management, modifications to road access
  • Construction on-costs: general prelims and management, temporary electrics package (rate per m2), scaffold and access package (rate per m2), final clean (rate per m2), fixed price allowance, main contractor’s: pre-construction fees, design fees, risk and overheads & profit/P23 fee.
  • Project Fees: consultant fees, in-house staff costs, surveys and investigations, legal fees
  • Direct Costs: non-works, equipment, IT & digital system enhancements (excluded)
  • Risk & Optimism Bias: planning contingency, optimism bias
  • Inflation: tender price inflation
  • Value Added Tax: VAT on all costs other than fees, VAT recovery on refurbishment works, VAT recovery on business activity works (i.e. car parking)


Southport:

  • Deck Car Park: deck car park, barrier height extension, foundations (pads), foundations (ramp), drainage connections, CBR testing (5 nr locations), ground radar and drainage survey, external lighting, external CCTV, power and data supplies (including BWIC), height limit barriers, lightning protection (earthing pits)
  • Lower-Level Surface Parking: break out existing tarmac, excavate to reduced levels, hardcore sub-base and geotextile barrier, tarmac surfacing, white lining, drainage installations
  • Surface Parking: surface level car park (including surfacing and kerbs), groundworks, make good retained building interfaces, drainage to new car park, drainage modifications to existing, CBR testing (5 nr locations), ground radar and drainage survey, external lighting, external CCTV, power and data supplies (including BWIC), white lining, lightning protection (earthing pits)
  • Other Site Works: traffic management, modifications to road access
  • Construction on-costs: main contractor general prelims and management, temporary electrics package (rate per m2), scaffold and access package (rate per m2), final clean (rate per m2), fixed price allowance, main contract’s: pre-construction fees, design fees, risk, overheads & profit / P23 fee.
  • Project Fees: consultant fees, in-house staff costs, surveys and investigations, legal fees
  • Direct Costs: non-works, equipment, IT & digital system enhancements (excluded)
  • Risk & Optimism Bias: planning contingency, optimism bias
  • Inflation: tender price inflation
  • Value Added Tax: VAT on all costs other than fees, VAT recovery on refurbishment works, VAT recovery on business activity works (i.e. car parking)